Review Article| Volume 41, ISSUE 1, P1-14, February 2023

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Preparticipation Cardiac Evaluation from the Pediatric Perspective

Published:October 20, 2022DOI:


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        • Erickson C.C.
        • Salerno J.C.
        • Berger S.
        • et al.
        Sudden death in the young: Information for the primary care provider.
        Pediatrics. 2021; 148
        • LaBotz M.
        • Bernhardt D.T.
        Preparticipation physical examination: is it time to stop doing the sports physical?.
        Br J Sports Med. 2017; 51: 152
        • Gajewski K.K.
        • Saul J.P.
        Sudden cardiac death in children and adolescents (excluding Sudden Infant Death Syndrome).
        Ann Pediatr Cardiol. 2010; 3: 107-112
        • Katritsis D.G.
        • Gersh B.J.
        • Camm A.J.
        A clinical perspective on sudden cardiac death.
        Arrhythmia Electrophysiol Rev. 2016; 5: 177-182
        • Harmon K.G.
        • Asif I.M.
        • Maleszewski J.J.
        • et al.
        Incidence, cause, and Comparative frequency of sudden cardiac death in National collegiate athletic association athletes: a decade in review.
        Circulation. 2015; 132: 10-19
        • Burns K.M.
        • Cottengim C.
        • Dykstra H.
        • et al.
        Epidemiology of sudden death in a population-based study of infants and children.
        J Pediatr X. 2020; 2
        • Winkel B.G.
        • Risgaard B.
        • Sadjadieh G.
        • et al.
        Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting.
        Eur Heart J. 2014; 35: 868-875
        • Maron B.J.
        • Doerer J.J.
        • Haas T.S.
        • et al.
        Sudden deaths in young competitive athletes analysis of 1866 deaths in the United States, 1980-2006.
        Circulation. 2009; 119: 1085-1092
        • Maron B.J.
        • Seidman J.G.
        • Seidman C.E.
        Proposal for contemporary screening strategies in families with hypertrophic cardiomyopathy.
        J Am Coll Cardiol. 2004; 44: 2125-2132
        • Faivre L.
        • Masurel-Paulet A.
        • Collod-Béroud G.
        • et al.
        Clinical and molecular study of 320 children with Marfan syndrome and related type I fibrillinopathies in a Series of 1009 probands with pathogenic FBN1 mutations.
        Pediatrics. 2009; 123: 391-398
        • Faivre L.
        • Collod-Beroud G.
        • Child A.
        • et al.
        Contribution of molecular analyses in diagnosing Marfan syndrome and type I fibrillinopathies: an international study of 1009 probands.
        J Med Genet. 2008; 45: 384-390
        • Corrado D.
        • Fontaine G.
        • Marcus F.I.
        • et al.
        Arrhythmogenic right ventricular Dysplasia/cardiomyopathy.
        Circulation. 2000; 101
        • te Riele A.S.J.M.
        • James C.A.
        • Sawant A.C.
        • et al.
        Arrhythmogenic right ventricular Dysplasia/cardiomyopathy in the pediatric population.
        JACC: Clin Electrophysiol. 2015; 1: 551-560
        • DeWitt E.S.
        • Chandler S.F.
        • Hylind R.J.
        • et al.
        Phenotypic Manifestations of arrhythmogenic cardiomyopathy in children and adolescents.
        J Am Coll Cardiol. 2019; 74: 346-358
        • Steinmetz M.
        • Krause U.
        • Lauerer P.
        • et al.
        Diagnosing ARVC in pediatric patients Applying the revised task Force criteria: importance of imaging, 12-lead ECG, and genetics.
        Pediatr Cardiol. 2018; 39
        • Etoom Y.
        • Govindapillai S.
        • Hamilton R.
        • et al.
        Importance of CMR within the task Force criteria for the diagnosis of ARVC in children and adolescents.
        J Am Coll Cardiol. 2015; 65: 987-995
        • Malhotra A.
        • Dhutia H.
        • Finocchiaro G.
        • et al.
        Outcomes of cardiac screening in adolescent soccer players.
        N Engl J Med. 2018; 379: 524-534
        • Miller S.M.
        • Peterson A.R.
        The sports preparticipation evaluation practice gaps.
        (Available at:)
        • Maron B.J.
        • Zipes D.P.
        • Kovacs R.J.
        Eligibility and Disqualification recommendations for competitive athletes with cardiovascular abnormalities: Preamble, principles, and general considerations.
        (Available at:)
        • Carek P.J.
        • Futrell M.
        • Hueston W.J.
        The preparticipation physical examination history: who has the correct answers?.
        Clin J Sport Med. 1999; 9
        • McCrindle B.W.
        • Rowley A.H.
        • Newburger J.W.
        • et al.
        Diagnosis, treatment, and long-term Management of Kawasaki disease: a scientific statement for health professionals from the American heart association.
        Circulation. 2017; 135: e927-e999
        • Barbut G.
        • Needleman J.P.
        Pediatric chest pain Education gaps.
        (Available at:)
        • Cannon B.
        • Wackel P.
        Syncope Educational Gap.
        (Available at:)
        • Martinez M.W.
        • Tucker A.M.
        • Bloom O.J.
        • et al.
        Prevalence of inflammatory heart disease among professional athletes with prior COVID-19 infection who received systematic return-to-play cardiac screening.
        JAMA Cardiol. 2021; 6: 745-752
        • Moulson N.
        • Petek B.J.
        • Drezner J.A.
        • et al.
        SARS-CoV-2 cardiac Involvement in young competitive athletes.
        Circulation. 2021; 144: 256-266
        • Corrado D.
        • Pelliccia A.
        • Bjørnstad H.H.
        • et al.
        Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus statement of the study group of sport cardiology of the working group of cardiac Rehabilitation and exercise Physiology and the working group of myocardial and Pericardial diseases of the European Society of cardiology.
        Eur Heart J. 2005; 26
        • Corrado D.
        • Basso C.
        • Pavei A.
        • et al.
        Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program.
        JAMA. 2006; 296
        • Steinvil A.
        • Chundadze T.
        • Zeltser D.
        • et al.
        Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death: Proven fact or wishful thinking?.
        J Am Coll Cardiol. 2011; 57: 1291-1296
        • HANEDA N.
        • MORI C.
        • NISHIO T.
        • et al.
        Heart diseases discovered by mass screening in the schools of Shimane prefecture over a period of 5 years.
        Jpn Circ J. 1986; 50
        • Drezner J.A.
        • O’Connor F.G.
        • Harmon K.G.
        • et al.
        AMSSM position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations and future directions.
        Br J Sports Med. 2017; 51: 153-167
        • Petek B.J.
        • Baggish A.L.
        Current controversies in pre-participation cardiovascular screening for young competitive athletes.
        Expert Rev Cardiovasc Ther. 2020; 18: 435-442
        • Orchard J.J.
        • Neubeck L.
        • Orchard J.W.
        • et al.
        ECG-based cardiac screening programs: Legal, ethical, and logistical considerations.
        Heart Rhythm. 2019; 16: 1584-1591
        • Sharma S.
        • Drezner J.A.
        • Baggish A.
        • et al.
        International recommendations for electrocardiographic interpretation in athletes.
        Eur Heart J. 2018; 39
        • Harmon K.G.
        • Zigman M.
        • Drezner J.A.
        The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/meta-analysis.
        J Electrocardiol. 2015; 48: 329-338
        • Yoshinaga M.
        • Horigome H.
        • Ayusawa M.
        • et al.
        Electrocardiographic diagnosis of hypertrophic cardiomyopathy in the pre- and Post-diagnostic phases in children and adolescents.
        Circ J. 2021; (CJ-21-0376)
        • Magavern E.F.
        • Badalato L.
        • Finocchiaro G.
        • et al.
        Ethical considerations for genetic testing in the context of mandated cardiac screening before athletic participation.
        Genet Med. 2017; 19: 493-495
        • Angelini P.
        • Muthupillai R.
        • Lopez A.
        • et al.
        Young athletes: Preventing sudden death by adopting a modern screening approach? A critical review and the opening of a debate.
        Int J Cardiol Heart Vasc. 2021; 34: 100790